Inguinal hernia surgery in Korea: nationwide data from 2007-2015

Abstract

Purpose: The aim of this study is to analyze inguinal hernia in Korea based on the nationwide data.

Methods: Retrospective analysis of nationwide data obtained from the Health Insurance Review & Assessment Service database for surgical repair of inguinal hernia from January, 2007 to December, 2015 was performed.

Results: A total of 314,238 cases of inguinal hernia surgery were performed during 9 years. The mean number of inguinal hernia surgery per year was 34,604 (range, 30,065-36,928). The proportion of male patient was 87%. Patients between the age of 1 to 5 years (17.3%) and of 60 to 69 years (17.4%) constituted the 2 dominant groups for inguinal hernia repair. A slight increase in repair for recurrent inguinal hernia, 1.9% to 3.2%, was observed from 2007 to 2015. The rate of concurrent bowel resection decreased from 1.9% to 0.6%. The total cost of inguinal hernia surgery was increased up to 1.68 times from 2007 to 2015 ($856 to $1,439), although the number of hospital days was decreased from 4.7 to 3.7 days. The rate of laparoscopic surgery was increased to 29.5% in 2015.

Conclusion: A mean number of 34,604 cases of inguinal hernia surgery have been carried out annually in Korea. The age distribution for inguinal hernia repair demonstrates bimodal peak at early childhood and old age. The proportion of laparoscopic surgery of inguinal hernia has been increasing for the past 9 years. The length of hospital stay and the rate of combined bowel resection have decreased.

Keywords: Diagnosis-related groups; Inguinal hernia; Nationwide.

Fig. 1. Trend of proportion of laparoscopic (LAP) and diagnosis-related group (DRG) based inguinal hernia repairs: (A) total inguinal hernia repairs, (B) adult group (>20 years), (C) pediatric group (<10 years).

Fig. 2. Distribution of inguinal hernia repairs according to age in Korea for 9 years.

Fig. 3. Trend of total medical cost (United States dollar, USD) of inguinal hernia repair by year.

Fig. 4. Trend of total hospital day of inguinal hernia repair by year. Total hospital day is defined by the day of hospitalization and the day of visiting in outpatient clinic. PED, pediatric patient.

Fig. 5. Distribution of medical providers performing inguinal hernia repairs: (A) total inguinal hernia repairs, (B) adult group, and (C) pediatric group.

Fig. 6. Distribution of inguinal hernia repairs by procedures: (A) total inguinal hernia repairs, (B) adult group, and (C) pediatric group.

Fig. 7. Trend of proportion of inguinal hernia repair with bowel resection for 9 years. PED, pediatric patient.

Fig. 8. Trend of proportion of recurrent inguinal hernia repair for 9 years. PED, pediatric patient.

Fig. 9. Trend of proportion of femoral hernia repair for 9 years. PED, pediatric patient.